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Related Concept Videos

The Auditory Ossicles01:11

The Auditory Ossicles

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The auditory ossicles of the middle ear transmit sounds from the air as vibrations to the fluid-filled cochlea. The auditory ossicles consist of two malleus (hammer) bones, two incus (anvil) bones, and two stapes (stirrups), one on each side. These bones develop during the fetal stage and are the ones to ossify first. They are fully mature at birth and do not grow afterward.
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Objective Measurements of Ossicular Chain Mobility Using a Palpating Instrument Intraoperatively.

Thomas E Linder1, Gabriel Volkan, Esther Troxler

  • 1*Department of Otorhinolaryngology, Head and Neck Surgery †Fisch International Microsurgery Foundation (FIMF), Luzerner Kantonsspital (LUKS), Luzern, Switzerland.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|October 21, 2015
PubMed
Summary
This summary is machine-generated.

Surgeons can now objectively measure middle ear ossicle mobility using a new force-sensing probe. This instrument supports subjective assessments with precise, three-dimensional force and vector data for improved diagnosis.

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Area of Science:

  • Otolaryngology
  • Biomedical Engineering
  • Surgical Instrumentation

Background:

  • Middle ear ossicle mobility assessment traditionally relies on subjective surgeon palpation.
  • This subjective method is highly dependent on individual surgeon experience and expertise.
  • Objective measurement is needed to support clinical judgment in evaluating ossicle mobility.

Purpose of the Study:

  • To develop and validate a novel palpating instrument for objective measurement of middle ear ossicle mobility.
  • To integrate force and vector recording capabilities into a handheld surgical probe.
  • To provide surgeons with objective data to complement their tactile assessment of ossicle function.

Main Methods:

  • A fiberoptic force-sensing element was integrated into a 45-degree hook probe, measuring forces in three orthogonal directions.
  • The instrument was tested in temporal bones and utilized in a clinical setting with patients undergoing cochlear implant (CI) surgery and those with otosclerosis.
  • An independent observer recorded applied force and vector during palpation until initial ossicle movement was observed.

Main Results:

  • The developed probe demonstrated a minimum detectable force change of 0.2 gF (2 mN).
  • In otosclerosis patients, forces to move the malleus and incus ranged from 6.9 to 9.5 gF, with significantly higher rigidity (14.7 gF or higher) for fixed stapes.
  • In the CI group with normal ossicles, forces were lower, ranging from 3.3 to 4.4 gF.

Conclusions:

  • A disposable, user-friendly palpating probe was successfully developed for continuous, three-dimensional force recording during ossicle palpation.
  • The study established normative force values for individual ossicles.
  • Objective data confirmed increased stapes fixation rigidity in otosclerosis patients, supporting clinical findings.